The evaluation of an athlete with a suspected concussion should be prompt and thorough.

Treatment is individualized according to patient age, concussion history, symptoms, signs and type of sport. All concussed athletes should be cleared for return to play by a sports medicine professional.

Based on the Summary and Agreement Statement of the First International Conference on Concussion in Sport, Vienna 2001

(www.bjsportmed.com <http://www.bjsportmed.com>)

Concussion in Sport Group (CISG) Protocol

Acute Response: When a player shows ANY symptoms or signs of a concussion:

* The player should not be allowed to return to play in the current game or practice.

* The player should not be left alone; and regular monitoring for deterioration is essential.

* The player should be medically evaluated after the injury.

* Return to play must follow a medically supervised stepwise process.

* A player should never return to play when symptomatic. "When in doubt, sit them out!"

Symptoms

Signs

Unaware of situation

Loss of consciousness

Confusion

Altered mental status

Amnesia

Poor coordination

Loss of consciousness

Slow to answer

Headache

Poor concentration

Dizziness

Nausea or vomiting

Nausea

Vacant stare

Loss of balance

Slurred speech

Flashing lights

Personality changes

Ear ringing

Inappropriate emotions

Blurred or double vision

Abnormal behavior

Sleepiness

Feeling dazed

Return to Play Protocol

Return to play after a concussion follows a stepwise process:

*Proceed to the next level if free of symptoms at the current level

*If any symptoms or signs occur, drop back to the previous level and progress to the next level again after 24 hours